Arda Borlu

Tularemia outbreaks in Kayseri, Turkey: An evaluation of the effect of climate change and climate variability on tularemia outbreaks

OBJECTIVES The aim of this study was to evaluate the epidemiological characteristics of tularemia outbreak and the effect of climate variability on this outbreak in Kayseri. METHODS The outbreak places, infection dates, source of infection, and the number of cases were recorded and analyzed. This information was obtained from the Regional Public Health Department. Climate data were supplied by the Regional Meteorological Service. RESULTS The first case in Sariz was recorded in 2005. Thereafter, 2 cases were reported in 2006 and 1 case in 2007. During 2010, 21 cases were recorded in 7 towns, 62 cases in 2011 and 27 cases in 2012. A total number of 110 cases were recorded in 12 out of 16 towns in Kayseri Province between 2010 and 2012. The majority of cases were seen in the north-eastern, east and south-eastern parts of Kayseri Province; located in higher altitudes (over 1000m from sea level). It was accepted that the outbreak was originated from water sources and was confirmed by few number of water samples collected from outbreak areas. Considering climate variations, the outbreak occurred between 1988 and 2009 during a dry, low humid, high temperature period after rainy season. CONCLUSION A tularemia outbreak was observed between 2010 and 2012 with the initiation of rainy years. High temperature for a long period accompanied by low rainfall and low humidity may affect the vectors biology and initiate a tularemia outbreak in high plateaus in Kayseri Province and around.

Neck Circumference to Assess Obesity in Preschool Children

Objective: Limited information is available about the use of neck circumference (NC) to assess obesity in preschool children. This study aims to provide NC percentiles and determine the cut-off levels of NC as a measure to assess obesity in preschool children. Methods: The data were obtained from the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study database. A total of 21 family health centers were chosen and children aged 2-6 years old from all socioeconomic levels were randomly selected from the lists of district midwives; 1766 children (874 male and 892 female; 88.3% of sample size) were included in the study. The smoothed centile curves of NC were constructed by the LMS method. Receiver operating characteristic (ROC) analysis was performed to calculate cut-off points for NC using body mass index ≥95th percentile. Results: Mean NC was greater in males than females. Cut-off values for obesity were found to be statistically significant in both genders other than 3 years old boys. The NC percentiles of Turkish preschool children were slightly greater than those of other European preschool children in both genders. This difference disappeared around the adiposity rebound period. The 97th percentile values for Turkish preschool children continue to be greater in both genders. Conclusion: NC may be useful to define obesity in preschool children. Since ethnic and various other factors may have a role in incidence of obesity, local reference data are important in assessment of obesity.

Risk factors for overweight and obesity in children aged 2-6 years.

Abstract Background: Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2–6 years in a central Anatolian city in Turkey. Methods: A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2–6 years were included from the Anthropometry of Turkish Children aged 0–6 years database. Age, gender, birth weight, birth order, mother’s age, mother’s body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother’s and father’s education, mother’s job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. Results: Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237–3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032–1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056–8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2–6 years old. Conclusions: The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.

Opinions and Behaviors on Use of Packaged Water Among the People Applying to Family Health Centers in Kayseri City Center

Objective: This study was purposed to determine the opinions and behaviours on use of packaged water among the people applying to family health centres in Kayseri city centre. Methods: The cross-sectional and descriptive survey was conducted on 1143 people aged 18 years and over who applied to Family Health Centers (ASM) located in Kayseri city center at February-March 2015. The data were gathered via questionnaire. SPSS 15.0 statistical package program was used for analyzing the data evaluated in the computer. Chi-square tests were used for comparisons, p<0.05 was considered significant. Results: The rate of preference of packed water for drinking was found to be 18.1%. Only 38.5% of the participants was believing in the cleanliness of tap water. Most preferred reasons for packed water were; ease of handling (50.4%), thought to be clean (36.5%) and dislike of tap water (20.4%). The packaged water consumption was higher among the people who were unmarried, in the 18-25 age group, in good economic status, having not child, living with two or three person in same house. ÖZET Amaç: Bu çalışma, Kayseri il merkezlerindeki aile sağlığı merkezlerine başvuranların içme suyu olarak ambalajlı su kullanımıyla ilgili düşünce ve davranışlarını ortaya koymayı amaçlandı. Yöntem: Kesitsel ve tanımlayıcı tipte olan araştırma 2015 yılı Şubat-Mart aylarında Kayseri merkez ilçelerinde bulunan aile sağlığı merkezlerine (ASM) başvuran 18 yaş ve üstü 1143 kişi üzerinde gerçekleştirildi. Veriler yüzyüze görüşülerek anket aracılığıyla toplandı. Bilgisayar ortamında değerlendirilen verilerin analizlerinde SPSS 15.0 istatistik paket programı kullanıldı. Karşılaştırmalarda ki kare testi kullanıldı ve p<0,05 anlamlı kabul edildi. Bulgular: İçme suyu olarak her zaman ambalajlı su tercih etme oranı %18,1 olarak bulundu. Tüm katılımcıların %38,5’ i şebeke suyunun temiz olduğunu düşünmekteydi. Ambalajlı suyun en fazla tercih sebepleri sırasıyla; taşıma kolaylığı (%50,4), temiz olduğu düşüncesi (%36,5) ve musluk suyunun tadını sevmeme (%20,4) idi. Evli olmayanlarda, 18-25 yaş grubunda olanlarda, çocuk sahibi olmayanlarda, ekonomik durumu iyi olanlarda, evde yaşayan kişi sayısı üç ile beş arasında olanlarda ambalajlı su tüketimi daha fazla bulundu. 1Erciyes Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, KAYSERİ İletişim / Corresponding Author : Arda BORLU Erciyes Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, 38030, Kayseri Türkiye Tel : +90 352 207 66 66 E-posta / E-mail : ardaborlu@gmail.com DOI ID : 10.5505/TurkHijyen.2017.21932 Türk Hijyen ve Deneysel Biyoloji Dergisi Borlu A, Balcı E, Öztürk A. Kayseri il merkezinde Aile Sağlığı Merkezlerine başvuranların hazır su kullanımına ilişkin görüş ve davranışları. Turk Hij Den Biyol Derg, 2017; 74(EK-1): 113-118 Makale Dili “Türkçe”/Article Language “Turkish” 2. ULUSLARARASI SU VE SAĞLIK KONGRESİ 2017

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination.

BACKGROUND This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. MATERIALS AND METHODS The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. RESULTS Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. CONCLUSIONS The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.